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A multi-modal computational fluid dynamics model of left atrial fibrillation haemodynamics validated with 4D flow MRI.

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Title: A multi-modal computational fluid dynamics model of left atrial fibrillation haemodynamics validated with 4D flow MRI.
Authors: Parker, Louis1,2,3 (AUTHOR), Bollache, Emilie1,2 (AUTHOR), Soulez, Shannon1,2 (AUTHOR), Bouazizi, Khaoula1,2 (AUTHOR), Badenco, Nicolas2,4 (AUTHOR), Giese, Daniel5 (AUTHOR), Gandjbakhch, Estelle2,4 (AUTHOR), Redheuil, Alban1,2,6 (AUTHOR), Laredo, Mikael1,2,4 (AUTHOR), Kachenoura, Nadjia1,2 (AUTHOR) nadjia.kachenoura@inserm.fr
Source: Biomechanics & Modeling in Mechanobiology. Feb2025, Vol. 24 Issue 1, p139-152. 14p.
Subjects: Computational fluid dynamics, Magnetic resonance imaging, Fluid mechanics, Atrial fibrillation, Mitral valve
Abstract: Atrial fibrillation (AF) is characterized by rapid and irregular contraction of the left atrium (LA). Impacting LA haemodynamics, this increases the risk of thrombi development and stroke. Flow conditions preceding stroke in these patients are not well defined, partly due the limited resolution of 4D flow magnetic resonance imaging (MRI). In this study, we combine a high-resolution computed tomography (CT) LA reconstruction with motion and pulmonary inflows from 4D flow MRI to create a novel multimodal computational fluid dynamics (CFD) model, applying it to five AF patients imaged in sinus rhythm (24 ± 39 days between acquisitions). The dynamic model was compared with a rigid wall equivalent and the main flow structures were validated with 4D flow MRI. Point-by-point absolute differences between the velocity fields showed moderate differences given the sensitivity to registration. The rigid wall model significantly underestimated LA time-averaged wall shear stress (TAWSS) (p = 0.02) and oscillatory shear index (OSI) (p = 0.02) compared to the morphing model. Similarly, in the left atrial appendage (LAA), TAWSS (p = 0.003) and OSI (p < 0.001) were further underestimated. The morphing model yielded a more accurate mitral valve waveform and showed low TAWSS and high OSI in the LAA, both associated with thrombus formation. We also observed a positive correlation between indexed LA volume and endothelial cell activation potential (ECAP) (R2 = 0.83), as well as LAA volume and LAA OSI (R2 = 0.70). This work demonstrates the importance of LA motion in modelling LAA flow. Assessed in larger cohorts, LAA haemodynamic analysis may be beneficial to refine stroke risk assessment for AF. [ABSTRACT FROM AUTHOR]
Copyright of Biomechanics & Modeling in Mechanobiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: A multi-modal computational fluid dynamics model of left atrial fibrillation haemodynamics validated with 4D flow MRI.
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  Data: Atrial fibrillation (AF) is characterized by rapid and irregular contraction of the left atrium (LA). Impacting LA haemodynamics, this increases the risk of thrombi development and stroke. Flow conditions preceding stroke in these patients are not well defined, partly due the limited resolution of 4D flow magnetic resonance imaging (MRI). In this study, we combine a high-resolution computed tomography (CT) LA reconstruction with motion and pulmonary inflows from 4D flow MRI to create a novel multimodal computational fluid dynamics (CFD) model, applying it to five AF patients imaged in sinus rhythm (24 &#177; 39 days between acquisitions). The dynamic model was compared with a rigid wall equivalent and the main flow structures were validated with 4D flow MRI. Point-by-point absolute differences between the velocity fields showed moderate differences given the sensitivity to registration. The rigid wall model significantly underestimated LA time-averaged wall shear stress (TAWSS) (p = 0.02) and oscillatory shear index (OSI) (p = 0.02) compared to the morphing model. Similarly, in the left atrial appendage (LAA), TAWSS (p = 0.003) and OSI (p &lt; 0.001) were further underestimated. The morphing model yielded a more accurate mitral valve waveform and showed low TAWSS and high OSI in the LAA, both associated with thrombus formation. We also observed a positive correlation between indexed LA volume and endothelial cell activation potential (ECAP) (R2 = 0.83), as well as LAA volume and LAA OSI (R2 = 0.70). This work demonstrates the importance of LA motion in modelling LAA flow. Assessed in larger cohorts, LAA haemodynamic analysis may be beneficial to refine stroke risk assessment for AF. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Biomechanics &amp; Modeling in Mechanobiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10237-024-01901-y
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      – SubjectFull: Mitral valve
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              Text: Feb2025
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